This Notice explains how your Protected Health Information (PHI) may be used or disclosed and describes your rights under the Health Insurance Portability and Accountability Act (HIPAA).

I am required by law to:

• Maintain the privacy of your PHI
• Provide this Notice
• Follow the terms of this Notice

I may revise this Notice at any time. The updated version will be available upon request and posted in the office and on the website.

I. Uses and Disclosures for Treatment, Payment, and Operations

I may use or disclose your PHI without written authorization for:

Treatment

• Consultation with other licensed providers involved in your care

Payment

• Verifying insurance benefits, billing, or claims processing

Health Care Operations

• Quality improvement, clinical supervision, audits, or administrative functions

Note: Disclosures for treatment are not subject to the "minimum necessary" standard.

II. Uses and Disclosures Requiring Authorization

Psychotherapy Notes

These will not be used or disclosed without your written authorization except as allowed by law (e.g., emergencies, legal defense, oversight).

Marketing & Sale of PHI

Your PHI will never be used for marketing or sold.

III. Uses and Disclosures Permitted Without Authorization

These include:

• When required by law
• Public health reporting
• Mandated reporting of abuse or neglect
• To prevent serious and imminent threats
• Health oversight activities
• Court orders or lawful subpoenas
• Law enforcement requests
• Coroners or medical examiners
• Workers' compensation
• Appointment reminders

Research Clause Clarification (Virginia-Safe Addition)

This practice does not currently conduct research. This clause exists solely to comply with HIPAA requirements.

IV. Uses and Disclosures That Allow You to Object

I may disclose PHI to family or others involved in your care if you do not object. If you are unable to consent, professional judgment will be used.

V. Your HIPAA Rights

Request Restrictions

You may request limits on how your PHI is used. I am not required to agree unless the restriction is for a service you paid for out-of-pocket in full.

Confidential Communications

You may request that I contact you at a specific phone number, address, or method.

Inspect and Obtain Copies

You may request a paper or electronic copy of your PHI (excluding psychotherapy notes). A reasonable fee may apply.

Request Amendment

You may request corrections to your PHI. If denied, you will receive a written explanation.

Accounting of Disclosures

You may obtain a list of disclosures made in the prior six years (excluding TPO disclosures).

Right to a Copy of This Notice

You may request a paper or electronic copy at any time.

VI. Breach Notification (Required Under HIPAA)

If a breach of unsecured PHI occurs, you will be notified in accordance with the HIPAA Breach Notification Rule, including the steps you may take to protect yourself.

VII. Confidentiality in Psychotherapy (Virginia-Specific Mandates)

Information shared in therapy is confidential except when:

1. There is a serious and immediate risk of harm to self or others
2. There is suspected abuse or neglect of a child, elder, or vulnerable adult
3. Required by a court order
4. Responding to a lawful subpoena
5. You are court-ordered to treatment
6. Consultation is needed for your care (your identity may be withheld)

VIII. Social Media & Digital Communication

I do not accept friend or contact requests from clients on social media. Email and text should be used only for scheduling or administrative matters.

IX. Telehealth Services

All confidentiality protections apply to telehealth. Risks can include technical issues or limits on clinical observation. You may withdraw consent at any time.

X. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

U.S. Department of Health & Human Services – Office for Civil Rights

No retaliation will occur for filing a complaint.